Drug-resistant tuberculosis: Difference between revisions

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= Definition =
== Definition ==


* [[Tuberculosis]] infection that is resistant to both first-line drugs, isoniazid and rifampin
* [[Tuberculosis]] infection that is resistant to both first-line drugs, isoniazid and rifampin


= Management =
== Management ==


* 8 months of an intensive four-drug regimen that includes any four drugs to which it is susceptible, in order of preference:
* 8 months of an intensive four-drug regimen that includes any four drugs to which it is susceptible, in order of preference:

Revision as of 15:24, 17 August 2019

Definition

  • Tuberculosis infection that is resistant to both first-line drugs, isoniazid and rifampin

Management

  • 8 months of an intensive four-drug regimen that includes any four drugs to which it is susceptible, in order of preference:
    • Any first-line agents to which it is still susceptible
    • A fluoroquinolone (except ciprofloxacin)
    • An injectable: kanamycin, or other parenteral agent
    • Other second-line agents, starting with ethionamide
  • Followed by 12 months of a less intensive regimen (at least three effective drugs), for a total of at least 20 months

References

  1. ^  Bern-Thomas Nyang’wa, Catherine Berry, Emil Kazounis, Ilaria Motta, Nargiza Parpieva, Zinaida Tigay, Varvara Solodovnikova, Irina Liverko, Ronelle Moodliar, Matthew Dodd, Nosipho Ngubane, Mohammed Rassool, Timothy D. McHugh, Melvin Spigelman, David A.J. Moore, Koert Ritmeijer, Philipp du Cros, Katherine Fielding. A 24-Week, All-Oral Regimen for Rifampin-Resistant Tuberculosis. New England Journal of Medicine. 2022;387(25):2331-2343. doi:10.1056/nejmoa2117166.